| NPI | 1023379112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NV DO3839) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0102205313) |
| Enumeration Date | 2012-06-05 |
| Last Update Date | 2025-04-23 |